Breast cancer treatments may increase heart risk, doctors warn

Chemotherapy has saved the lives of millions of women with breast cancer, but it may have also damaged their hearts.

On Thursday, the American Heart Association gave a stark warning — women with breast cancer may be at increased risk of cardiovascular disease, including heart failure. The team of specialists cautioned that breast cancer patients and their doctors should weigh the benefits of specific treatments against potential harm to their hearts. It’s the first major report on a link between the two diseases.

There are three main reasons for heightened risk for cardiovascular disease for breast cancer survivors:

pre-existing heart risk factors, such as uncontrolled hypertension or high cholesterol that goes unchecked through their breast cancer treatment

exposure to chemotherapy and radiation that damage the heart

an increasingly sedentary lifestyle that leads to weight gain during the treatment phase

“Both breast cancer and cardiovascular disease share risk factors,” said Dr. Susan Gilchrist, a cardiologist at MD Anderson whose research focuses on cardiorespiratory fitness in cancer patients. “That includes weight gain, loss of exercise or sedentary behaviors, and metabolic dysfunction, which are a risks factor for breast cancer recurrence and cardiovascular disease.”

The greatest risk is from the chemotherapy drug doxorubicin, an anthracyclin. Eight treatments increase heart failure risk by 5 percent, up to a 48 percent increase after 14 doses, the doctors wrote in the statement.

But women with breast cancer are not encouraged to avoid treatment.

“Any patient who is going to undergo breast cancer treatment — whether they have heart disease at the beginning or not — should be aware of the potential effects of the treatments on their heart,” said Dr. Laxmi Mehta, chair of the AHA writing committee and director of the Women’s Cardiovascular Health Program at The Ohio State University in Columbus, Ohio. “This should not deter or scare patients from undergoing breast cancer treatment, but should allow them to make informed decisions with their doctor on the best cancer treatment for them.”

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